TRICARE Plus
TRICARE Plus Disenrollment Request form (DD Form 2854)
- Use this form to disenroll from TRICARE Plus.
- Submit a copy to the military hospital or clinic where you’re enrolled.
Last Updated 8/21/2025
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Are you displaced back to the United States? We’ve got you covered. Get details about how you continue to get health care and who to call if you have questions. Visit www.tricare.mil/displaced to learn more.
Patient Resources
Resources for patients.TRICARE Plus Disenrollment Request form (DD Form 2854)
Last Updated 8/21/2025